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Going National with Diabetes
By Anne Bennett
Swingle
With 17 million
Americans suffering from this once rare disease, Chris Saudek sounded
a wake-up call during his year as president of the American Diabetes Association.
It's a side effect of prosperity," Christopher Saudek says, when
he's asked about the rampant spread of diabetes. Saudek should know. As
outgoing president of the American Diabetes Association, this endocrinologist
has seen firsthand the sweeping grasp of this once rare condition. In
the United States alone, diabetes affects more than 17 million people.
Another 16 million Americans test with higher-than-normal blood glucose
levels, putting them in a new category known as "pre-diabetic."
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The Rockefeller Chronicle
By Anne Bennett
Swingle
For the first
half of the 20th century, the research center founded by America's most
powerful oil baron was all bound up with the School of Medicine.
In the summer of 1897 as Frederick Gates, a former Baptist minister
who had become John D. Rockefeller's most trusted advisor, vacationed
with his family on Lake Liberty in the Catskill Mountains, he began perusing
William Osler's Principles and Practice of Medicine. Gates was fascinated
with the scholarly approach to diagnosing and treating disease laid out
by Johns Hopkins Hospital's first physician-in-chief. And yet, he hungered
for more. "To a layman like me demanding cures, [Osler] had no word
of comfort," Gates wrote later.
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Devices & Desires
By Anne Bennett
Swingle
Photos Keith Weller
A diagnosis of
heart failure once signaled imminent death. Today, specialists are abuzz
with pacers, pumps and other implantable mechanisms that have changed
the picture for patients with this lethal condition.
There is no cure for heart failure. Half the people diagnosed with it
will be dead within five years. The heart gradually loses its ability
to pump blood; the victim feels a deadening fatigue, struggles to breathe,
and the lungs become congested with fluid. Luckily for most people with
the disease, drug therapy is hugely helpful. But for those who don't respond
to drugs or for some unknown reason stop responding there has been little
aside from a transplant to make the damaged heart function effectively
again.
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Better Send it to Epstein
By Janet Farrar
Worthington
Prostate cancer
cells may be the hardest of all to analyze. and they can spell big trouble.
One pathologist has deciphered more of these splotchy microscopic patterns
than anyone else in the world.
You are a man who may or may not have prostate cancer, and you are sweating
bullets. You're still sore from the needle biopsy, and you're waiting
for some guy you've never met-some faceless pathologist- to make the call.
Is it cancer? Is it treatable? Now, switch roles: You are that pathologist,
and a man's life may depend on what you can glean from a few tiny cores
of prostate tissue. Did the urologist who sent you the biopsy nail the
cancer, or miss it entirely? Consider that the prostate gland is roughly
the size of a large strawberry and in it, a patch of cancer-the average
cancerous prostate has about seven-is about the size of a strawberry seed.
The cancer cells that are found generally tend to be hard to interpret;
thus, biopsy is often a hit-and-miss affair. And now it's in your court.
Your judgment will be a major part of the treatment decision-making. Is
it cancer? Maybe yes, maybe no. The best you can determine is that it's
"atypical." Better send it to Epstein.
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